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Reference Manager
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1.
Wilder-Smith A, Schwartz E, 2005. Dengue in travelers. N Engl J Med 353: 924–932.
-
2.
Simmons CP, Farrar JJ, Nguyen VV, Wills B, 2012. Dengue. N Engl J Med 366: 1423–1432.
-
3.
Ali N, Usman M, Syed N, Khurshid M, 2007. Haemorrhagic manifestations and utility of haematological parameters in dengue fever: a tertiary care centre experience at Karachi. Scand J Infect Dis 39: 1025–1028.
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4.
Wilder-Smith A, Earnest A, Paton NI, 2004. Use of simple laboratory features to distinguish the early stage of severe acute respiratory syndrome from dengue fever. Clin Infect Dis 39: 1818–1823.
-
5.
Chadwick D, Arch B, Wilder-Smith A, Paton N, 2006. Distinguishing dengue fever from other infections on the basis of simple clinical and laboratory features: application of logistic regression analysis. J Clin Virol 35: 147–153.
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6.
Nathan C, 2006. Neutrophils and immunity: challenges and opportunities. Nat Rev Immunol 6: 173–182.
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7.
Beers MH, Berkow R, 1999. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories.
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8.
World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization.
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9.
Lee VJ, Chow A, Zheng X, Carrasco LR, Cook AR, Lye DC, Ng LC, Leo YS, 2012. Simple clinical and laboratory predictors of chikungunya versus dengue infections in adults. PLoS Negl Trop Dis 6: e1786.
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10.
La Russa VF, Innis BL, 1995. Mechanisms of dengue virus-induced bone marrow suppression. Baillieres Clin Haematol 8: 249–270.
-
11.
Hoang LT, Lynn DJ, Henn M, Birren BW, Lennon NJ, Le PT, Duong KT, Nguyen TT, Mai LN, Farrar JJ, Hibberd ML, Simmons CP, 2010. The early whole-blood transcriptional signature of dengue virus and features associated with progression to dengue shock syndrome in Vietnamese children and young adults. J Virol 84: 12982–12994.
-
12.
Pancharoen C, Mekmullica J, Thisyakorn U, 2001. Primary dengue infection: what are the clinical distinctions from secondary infection? Southeast Asian J Trop Med Public Health 32: 476–480.
-
13.
Phan DT, Ha NT, Thuc LT, Diet NH, Phu LV, Ninh LY, An VT, 1991. Some changes in immunity and blood in relation to clinical states of dengue hemorrhagic fever patients in Vietnam. Haematologia (Budap) 24: 13–21.
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14.
Murillo-Llanes J, Soto-Valenzuela H, Flores-Flores P, Peraza-Garay F, 2007. Clinical and epidemiological characteristic of dengue. Rev Med Inst Mex Seguro Soc 45: 485–491.
-
15.
Khan NA, Azhar EI, El-Fiky S, Madani HH, Abuljadial MA, Ashshi AM, Turkistani AM, Hamouh EA, 2008. Clinical profile and outcome of hospitalized patients during first outbreak of dengue in Makkah, Saudi Arabia. Acta Trop 105: 39–44.
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16.
Lee IK, Liu JW, Yang KD, 2012. Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations. PLoS Negl Trop Dis 6: e1532.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1541 | 1128 | 69 |
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| PDF Downloads | 281 | 18 | 0 |
Severe Neutropenia in Dengue Patients: Prevalence and Significance
Tun-Linn Thein
Tun-Linn Thein
Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, Singapore
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David C. Lye
David C. Lye
Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, Singapore
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Yee-Sin Leo
Yee-Sin Leo
Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, Singapore
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Joshua G. X. Wong
Joshua G. X. Wong
Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, Singapore
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Ying Hao
Ying Hao
Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, Singapore
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Annelies Wilder-Smith
Annelies Wilder-Smith
Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, Singapore
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Studies on severe neutropenia in dengue are scarce, and its clinical significance is uncertain. We analyzed a cohort of 1,921 reverse transcription polymerase chain reaction-confirmed adult dengue patients admitted to the Communicable Disease Center in Singapore between 2005 and 2008. Time trend analyses for daily absolute neutrophil counts (ANCs) were done using Bayesian hierarchical and Markov models. We found that severe neutropenia, defined as ANC ≤ 0.5 × 109/L, was found in 11.8% with a median duration of 1 day. ANC nadir occurred on illness day 5. Severe neutropenia was not predictive of more severe disease and not associated with secondary bacterial infections, prolonged hospital stay, prolonged fever, or fatal outcome. We concluded that prophylactic antibiotics are not indicated in patients with severe neutropenia without indication for bacterial infection.
Author Notes
Financial support: This work was supported by the STOP Dengue Translational Clinical Research Programme funded by the National Research Foundation through the National Medical Research Council, Singapore (Grant NMRC/TCR/005/2008).
Authors' addresses: Tun-Linn Thein, Joshua G. X. Wong, and Ying Hao, Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, E-mails: linn_thein_tun@ttsh.com.sg, Joshua_Gx_Wong@ttsh.com.sg, and ying_hao@ttsh.com.sg. David C. Lye, Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, and Yong Loo Lin School of Medicine, National University of Singapore, Singapore, E-mail: david_lye@ttsh.com.sg. Yee-Sin Leo, Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, and Yong Loo Lin School of Medicine, National University of Singapore, Singapore, and Saw Swee Hock School of Public Health, National University of Singapore, Singapore, E-mail: yee_sin_leo@ttsh.com.sg. Annelies Wilder-Smith, Communicable Disease Center, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, and Lee Kong Chian School of Medicine, Singapore, E-mail: awilder-smith@ntu.edu.sg.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Wilder-Smith A, Schwartz E, 2005. Dengue in travelers. N Engl J Med 353: 924–932.
-
2.
Simmons CP, Farrar JJ, Nguyen VV, Wills B, 2012. Dengue. N Engl J Med 366: 1423–1432.
-
3.
Ali N, Usman M, Syed N, Khurshid M, 2007. Haemorrhagic manifestations and utility of haematological parameters in dengue fever: a tertiary care centre experience at Karachi. Scand J Infect Dis 39: 1025–1028.
-
4.
Wilder-Smith A, Earnest A, Paton NI, 2004. Use of simple laboratory features to distinguish the early stage of severe acute respiratory syndrome from dengue fever. Clin Infect Dis 39: 1818–1823.
-
5.
Chadwick D, Arch B, Wilder-Smith A, Paton N, 2006. Distinguishing dengue fever from other infections on the basis of simple clinical and laboratory features: application of logistic regression analysis. J Clin Virol 35: 147–153.
-
6.
Nathan C, 2006. Neutrophils and immunity: challenges and opportunities. Nat Rev Immunol 6: 173–182.
-
7.
Beers MH, Berkow R, 1999. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories.
-
8.
World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization.
-
9.
Lee VJ, Chow A, Zheng X, Carrasco LR, Cook AR, Lye DC, Ng LC, Leo YS, 2012. Simple clinical and laboratory predictors of chikungunya versus dengue infections in adults. PLoS Negl Trop Dis 6: e1786.
-
10.
La Russa VF, Innis BL, 1995. Mechanisms of dengue virus-induced bone marrow suppression. Baillieres Clin Haematol 8: 249–270.
-
11.
Hoang LT, Lynn DJ, Henn M, Birren BW, Lennon NJ, Le PT, Duong KT, Nguyen TT, Mai LN, Farrar JJ, Hibberd ML, Simmons CP, 2010. The early whole-blood transcriptional signature of dengue virus and features associated with progression to dengue shock syndrome in Vietnamese children and young adults. J Virol 84: 12982–12994.
-
12.
Pancharoen C, Mekmullica J, Thisyakorn U, 2001. Primary dengue infection: what are the clinical distinctions from secondary infection? Southeast Asian J Trop Med Public Health 32: 476–480.
-
13.
Phan DT, Ha NT, Thuc LT, Diet NH, Phu LV, Ninh LY, An VT, 1991. Some changes in immunity and blood in relation to clinical states of dengue hemorrhagic fever patients in Vietnam. Haematologia (Budap) 24: 13–21.
-
14.
Murillo-Llanes J, Soto-Valenzuela H, Flores-Flores P, Peraza-Garay F, 2007. Clinical and epidemiological characteristic of dengue. Rev Med Inst Mex Seguro Soc 45: 485–491.
-
15.
Khan NA, Azhar EI, El-Fiky S, Madani HH, Abuljadial MA, Ashshi AM, Turkistani AM, Hamouh EA, 2008. Clinical profile and outcome of hospitalized patients during first outbreak of dengue in Makkah, Saudi Arabia. Acta Trop 105: 39–44.
-
16.
Lee IK, Liu JW, Yang KD, 2012. Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations. PLoS Negl Trop Dis 6: e1532.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1541 | 1128 | 69 |
| Full Text Views | 555 | 17 | 0 |
| PDF Downloads | 281 | 18 | 0 |